It’s also actually hard to really understand how any production based pay works until you’ve been at that particular practice for a while (especially how likely you are to make production, and by how much). Salary is straightforward. You know where your money is coming from and how. With production, how it’s calculated is not the same across the board. And your production is affected a ton by both the clinic policies/procedures as well as the behavior of everyone around you including yourself. I’ve been at some practices where I would get snippets of random rules that affect associate productions and have been like “whaaaaat!? That’s bonkers!!! You’re getting cheated big time! I can’t believe you continue to work here with this policy!!!”
So many seemingly little things can make a big difference in your production! Each of the following can increase or decrease my pay in the order of thousands over the course of a year
Like, how are tech appts handled outside of anal gland expression/nail trims? Does the doctor get production for vaccine boosters? What about heartworm tests? What about more extensive labwork? And if it’s a doctor, is it the doctor who is working appts that day or the one who saw the wellness appt? What about recheck labwork? For some places, the “hospital” gets credited for all tech appts instead of doctors.
Heck, what about any labwork? Who gets paid for it? The doctor who saw the pet and recommended it? The doctor who spoke with the owners about the results? And if the former, is there a rule at this hospital for the timeframe in which labs must be called back or is it whatever is agreed upon by the doctor on the case and client? If all labs MUST be called back the day it comes back, who gets stuck with that and do they get paid for it if the recommending doctor isn’t on?
If you hospitalize any patient overnight and need to transfer the case for another doctor to babysit the next day and discharge, does the second doctor get compensated anything for their time if all the diagnostics, procedures, and prescriptions are already under your name?
What about refills, who gets credit for that (hospital, the doctor who authorizes it, or the doctor who saw the patient last for the problem requiring the medication)? Do you have control over which support staff works with you? How are tasks that don’t result in production of any money handled-especially the time consuming (random client call backs, authorization for outside pharmacies)? Are all preventatives calculated the same? How about prescription diets?
if you’re paid prosal, how are you compensated for filling in an additional day? Just production? Just additional paid time off in addition to production? Or do you get paid what would amount to an “additional day’s worth of salary”? Or do you get paid as if you were relief?
how are “paid days off” like CE days, vacation, sick days, and holidays calculated? Even if there is no negative accrual, you are losing money if the hospital isn’t crediting you your average daily production for the day you didn’t work.
And how do these policies and flow of the clinic affect the behaviors of the doctors, especially if there are some at the same hospital being paid on production/salary/hourly? You’d like to think production pay wouldn’t affect the behavior of any doctor towards their clients or colleagues, but it always does to an extent. For example, in a busy multifoctor hospital where the authorizing dr gets credit for refills, I can easily knock out $1000 of rx refills in half an hour or less if I pick and choose the lucrative ones, and pocket $200 extra money assuming 20% production. Or I can be the team player that tackles the 1800petmeds rx that makes no sense and requires a phone call to the owner that you know is going to be long and unpleasant... takes up maybe even more time and I make $0. If you have doctors in the clinic who are production conscious and habitually take all the easy lucrative tasks and not take much of the time consuming scut work... it does not feel good first of all, and it can literally mean thousands of dollars that they are not sharing with you. At the end of the day, you are losing money for any time you spend performing low earning tasks.
Also, it’s really annoying to need to keep track of making sure charges are being captured under the right doctor.
It’s actually pretty complicated, and it’s hard for anyone to really navigate without knowing the clinic and its financials, and also difficult to compare one clinic from the next as far as how much money you will make on prosal. It’s really apples to oranges. I’m not sure it’s easy for a new grad to assess how and what they’re going to get paid on any production based pay, or how much stress/anguish it will cause. You simply just don’t know until you work there. And there’s no way I would have even known as a new grad to ask half of the questions I now would ask for any clinic offering to pay me on production based pay.
